Health: Atrial Fibrillation and Stroke

Lord Patel Excerpts

Tuesday 12th December 2017 Lords Chamber

[Lord O’Shaughnessy]

On the stroke strategy, a follow-on plan is being developed by NHS England and its partners, including the Stroke Association, which will take forward that approach. The noble Lord will also be pleased to know that it is an integrated-service approach including ambulances, community care and secondary care. On the point about reorganisation, he is quite right that London has seen excellent success through the specialisation and concentration of services, and we certainly encourage the rest of the country to do that too.

[Lord Patel (CB)]

My Lords, during the House of Lords Select Committee inquiry on the long-term sustainability of the NHS we heard a great deal of evidence demonstrating the great variations in care, in the treatment not only of atrial fibrillation but of other conditions. Is it not time that we made the NICE guidelines, which are very clear about the management of patients with atrial fibrillation, mandatory to reduce the variation in care and improve outcomes?

[Lord O’Shaughnessy]

As the noble Lord will know better than anyone, making them mandatory is a challenge because of the importance of clinical autonomy. What we can make mandatory is an understanding of those guidelines and that they inform every treatment pathway. That is part of what the NHS RightCare programme, which is now rolled out across the country, is doing. It is introducing new things such as stroke pathways so that there is clarity about the options available. Patient choice is at the centre of that decision.